The Body Odd – Head-spinning Meniere’s disease may have met its match.

By JoNel Aleccia

Dizzy doesn’t begin to describe Gene Pugnetti’s bouts of vertigo.

For at least four years, the 56-year-old Yakima, Wash., man has suffered repeated episodes of stomach-lurching, head-spinning disruptions in his equilibrium, attacks so severe that they require him to sit down, cover his eyes and wait an hour – until the Valium kicks in.

Just since February, Pugnetti has endured 45 such spells, all caused by what doctors diagnosed as a severe case of Meniere’s disease, an inner ear disorder that erodes victims’ hearing and leaves them vulnerable to unexpected vertigo. The most recent bout was three weeks ago.

“It was pretty bad,” said Pugnetti, an information technology worker, who has 65 percent hearing loss in his right ear. “Just, bang!, you’re focusing on something and then all of a sudden you can’t focus on anything.”

Pugnetti has tried almost everything to quell the problem, which affects some 615,000 people in the United States, according to the National Institutes of Health. Drugs, diet, exercise and even an implanted shunt failed to do the trick.

On Thursday, though, Pugnetti became the first person to be implanted with a new device aimed at stopping the vertigo as soon as it starts. Dr. Jay Rubinstein and Dr. James Phillips of the University of Washington’s otolaryngology-head and neck surgery department, assisted by a team of experts, chose Pugnetti as the first member of a 10-person clinical trial to test an invention four years in the making.

It’s the “UW/Nucleus Vestibular Implant,” a clunky name for the behind-the-ear device that’s basically a revamped version of a cochlear implant, an electronic aid typically used to help deaf people hear. In Meniere’s, the disease short-circuits the power supply that allows balance, Rubinstein said. The new device restores it by sending electrical impulses to electrodes implanted in the bony ear, disrupting the vertigo.

Once it’s turned on, in about three weeks, Pugnetti will be able to don the device at the first sign of dizziness, disarming symptoms ranging from mild to severe.

It won’t eliminate the Meniere’s, for which there is no certain cause or cure, but it should get rid of the worst effect. If the clinical trial is a success, the device that was tested in monkeys and approved in June by the Food and Drug Administration could find a wide audience of Meniere’s victims, says Pugnetti, who has no qualms about being first.

“The fact is, there are a whole lot of people who are out there suffering,” he said. “Just talking about this procedure to them gives them hope. And that’s a big deal.”

Mechanicsville, VA — Lately we’ve seen our share of vertigo suffers at Stover Chiropractic.  I appreciate the well written, short, piece from The Atlas of Life blog (upper cervical information) about vertigo and Meniere’s disease.  There is a great video clip of a testimony given by a previous vertigo sufferer.  Check it out: http://feedproxy.google.com/~r/TheAtlasOfLife/~3/Fc8fI_ZBdDI/

Burcon MT.  Upper Cervical Protocol for Ten Meniere’s Patients.  Ninth Annual Vertebral Subluxation Research Conference, October 13-14, 2001, Spartanburg, SC.  After presentation, it was published in the Journal of Vertebral Subluxation Research, on June 2, 2008, pp 1-8.

Meniere’s is a terrible condition.  Vertigo sets in suddenly and lasts up to 24 hours.  In addition to the vertigo there is nystagmus, tinnitus, brain fog, headaches, neck stiffness, sinus pain, and fatigue.  If the symptoms continue to recur despite lifestyle changes and medications, there are surgeries.  The surgeries are less than 60% effective.  The one that does “work,” a labyrinthectomy, causes deafness in that ear.

This paper reports 9 case studies in which the patients received upper cervical chiropractic care.  In all cases the correction of the upper cervical subluxation relieved symptoms!

The CDC has a very informative page on their website that tells how serious the problem actually is and the outcomes of falls. They give some practical tips for prevention, but obviously chiropractic care it not one of them. This is a shame because of the success chiropractic has with helping vertigo or dizziness.

There has been scientific support that neck problems can cause dizziness for quite some time. There has also been literature (for some time) that demonstrates chiropractic can help with dizziness and vertigo.

For example: Mayer B, Rieden K, Mende U. Importance of the General Radiograph of the Cervical Spine in Vertigo and Pathologic Proprioceptive Cervical Nystagmus. Laryngol Rhinol Otol (Stuttg), 1985; 64(6):300-303

This is an old paper, but I like it because it actually mentions chiropractic type therapy. Dr. Kirk Eriksen D.C. comments in Upper Cervical Subluxation Complex (p284): This paper looked at possible correlations between vertigo and cervical alterations as evidenced on radiographs. The authors draw a correlation due to the frequent elimination of symptoms by chirotherapy.

So if you or someone you know has trouble with balance, dizziness, vertigo, or stability, consider a spinal origin. Especially consider upper cervical dysfunction.

J Chiropr Med. 2005 Winter;4(1):32-8.
Chiropractic management of a patient with post traumatic vertigo of complex origin.
Collins ME, Misukanis TM.

Private practice of chiropractic, St. Paul, MN.
OBJECTIVE: To illustrate a case of vertigo in a patient with cervical spine injury and mild traumatic brain injury following a motor vehicle accident and present chiropractic and rehabilitative procedures used for management. CLINICAL FEATURES: A 30-year-old female had neck pain, head pain, a variety of cognitive problems, vertigo, and restricted cervical range of motion following a serious motor vehicle collision. Following several weeks of chiropractic management with positive progress the patient suddenly had worsening of the vertigo and the cognitive problems. Positional vertigo was ruled out by the emergency room doctors and a neurologist. A neuropsychological assessment indicated that mild traumatic brain injury was present. INTERVENTION: The patient began chiropractic treatment with both passive and active care, prior to the vertigo incident. Following the vertigo incident, treatment was modified to include 6 weeks of cervical exercises in clinic and at home. The patient reported resolution of the vertigo following the chiropractic treatment plan. CONCLUSION: This case reports presents an example of vertigo that improved under chiropractic management. This case illustrates the benefits of adding mild traumatic brain injury to differential diagnoses, co-managing care with other providers, and modifying treatment when necessary. Further research is suggested to study the contribution that chiropractic management could offer to those with neurological injury.